EFFECTIVENESS OF NEVIRAPINE AND COTRIMOXAZOLE PROPHYLAXIS AND OUTCOME OF BREASTFED BABIES BORN TO HIV POSITIVE MOTHERS IN SELECTED HOSPITALS IN BUSHENYI DISTRICT

ABSTRACT

Introduction: Globally, about 90% of children get HIV from their mothers during pregnancy, delivery, and breastfeeding. For a long time in Uganda vertical HIV transmission ranked second only to sexual transmission as the predominant mode of HIV infection in the country accounting for about 18% of new infections. In poor countries, HIV positive mothers are faced with the dilemma of either to breastfeed their children and increase the risk of transmitting HIV or not breastfeed and risk them dying of malnutrition and other infections. Nevirapine has been used in the PMTCT program in option B+ while Cotrimoxazole has been proved to protect against OIs and malaria in HEIs. The study aimed to find out the effectiveness of these two drugs amongst breastfed HEIs.

Objective: To determine the effectiveness of Nevirapine and Cotrimoxazole prophylaxis and the outcome of breastfed babies born to HIV-positive mothers in selected hospitals in the Bushenyi district.

Method: A retrospective cohort study design was employed. Both quantitative and qualitative approaches were utilized with a checklist as the main method of data collection. A total of 73record reviews were enrolled in the study.

Results: Six out of the total 73 HEIs turned positive on DNA-PCR with only one reported mortality. Only two of the positive cases had been on breastfeeding while four were exclusively on formula milk. Malaria, OIs, and death in the patient that succumbed was associated with home birth, Nevirapine initiation delay, and formula milk feeding.

Conclusion: Nevirapine and Cotrimoxazole prophylaxis are effective against MTCT of HIV and OIs and malaria respectively among breastfed HEIs. Transmission and mortality risk are lower among breastfed HEIs compared to those on formula milk. The study findings highlight the importance and effectiveness of NRP and Septrin prophylaxis in the current eMTCT strategy and the battle against the HIV/AIDS scourge in general.